Children and Youth with Thoughts of Suicide: Guide for Parents and Caregivers

Summary: When individuals are overwhelmed, whether by life stresses, or by conditions such as depression, they may turn to suicide as a way of coping. And although it is scary, the good news is that ultimately the person is trying to cope. Family and friends are absolutely critical, and can offer support in many ways, such as by spending time with the person, listening and validating the person, and helping ensure that the person seek professional help.

What is Suicide?

Suicide is the act of ending one's life. People can get thoughts about committing suicide for many reasons, such as when a person is under so many stresses that they become overwhelmed and cannot cope.

Typical stresses may include:

Home stress, such as conflict/disgreements with mother, father, siblings...

School stress such as problems with friends, schoolwork, teachers, bullies...

Work stress such as problems with co-workers, bosses, workload...

Other problems such as depression, anxiety, substance use

People can feel suicidal when they feel 1) disconnected from other people, 2) helpless to deal with their stress, and/or 3) hopeless that their stress will improve.

Thus, one way to help a young person who is feeling suicidal is to help 1) them feel connected again, and/or 2) overcome helplessness by giving them a sense of control, and/or 3) give them a sense of hope.

Warning Signs for Suicide

The following is a list of signs that may indicate someone is thinking about suicide. If your child exhibits only one or two things on this list, then it is probably not a big concern, but you would be much more worried if your child exhibits several of these warning signs:

Your child expresses feelings of worthlessness, such as, "I'm no good to anybody."

Your child talks about suicide and about what it would be like if things end. He or she may make comments such as, "When I'm gone ..." or ask questions such as, "What would it be like if I wasn't around?"

If You Are Worried Your Child May be Feeling Suicidal

E.g. You might start by saying, "How are you doing?", and then remember to give your loved one a chance to respond!

You might then express your concerns, e.g. you might say "I love and I'm worried about you these days."

You might then ask, "It seems like things have been stressful for you lately."

A nice gentle way to bring up the topic of suicide is then to say, "Does it ever get so stressful that you think life isn't worth living?"

If your child says yes, then you might proceed to ask, "Do you get any thoughts of doing something to end your life?"

If your child says YES to this, then seek immediate professional help.

This may include:

Calling 911

Calling a telephone crisis line

Calling a friend or doctor

And even if your child says "no" when you directly ask about thoughts of suicide, trust your instincts. If you are worried your child is in immediate danger of ending his/her life, then get help.

Ways to Support Someone Who is Passively Suicidal

If your child is not actively suicidal, but is nonetheless still having thoughts that life is not worth living, here are some possible things you might do:

First of all, seek professional help. Be a support, but remember that you are not a counsellor/therapist.

Listen and validate what your loved one is saying.

Thank the other person for sharing with you. "I didn't know you feeling so bad... Thanks for telling me."

Empathize, which means that you agree and acknowledge how bad the person feels, e.g. "Yeah, I can see that would be very difficult."

Don't say things such as "You shouldn't be feeling this way" or "You should count yourself lucky" because that may make the person feel guilty, and less likely to open up to you.

Don't invalidate or judge the other person for how they are feeling, even if you yourself wouldn't feel the same way.Don't say things such as... "How can you possibly feel this way? After all that we've done for you? Is this the way you repay us? How can you do this to us?" Such blame will most likely make your child feel worse, making it less likely that s/he will confide in you. And worse, in some cases such statements will only confirm to the child that s/he is a burden, increasing the risk of suicide.

Give hope. "This is going to get better. Things were better in the past; we'll get it back to how it was when things were better."

Tell the person they are not alone. "We're in this one together; we're going to help you get over this."

Offer your support, e.g. "How can I support you? How can I help you get over this?"

Help the person with problem-solving. People often think about suicide when they are overwhelmed by stress. And even if those stresses don't directly cause a person to feel suicidal, the stress nonetheless doesn't help. Things you might say to help problem-solving include:

"Sometimes people think of hurting themselves when they're under stress or trying to deal with some problem"

"What's the stress that your dealing with?"

"Is there some particular problem that you're trying to deal with?"

"I'm here for you and want to help you work through this..."

If you discover your relative after a suicide attempt:

1. Call 911 (or an ambulance) immediately.

2. If you know first aid, administer it immediately.

3. Phone someone to go with you to the hospital; or to stay with you at home.

4. After you come home from the hospital, do not try to handle things alone. Have other relatives or friends to talk to, and consider contacting a support group, or counselor/therapist for yourself as well.

Providing a safe home for a person who is feeling suicidal

Whenever someone has thoughts about suicide, whether those thoughts are active or not, make your home a safer place by removing potential sources of harm:

1. Remove firearms and weapons

Make sure that there are no firearms, ammunition nor weapons in the home. Remove any fire arms from the home by giving to a trusted friend/neighbour, or by taking them to the local police station if no other options can be found.

2. Remove alcohol

Since alcohol affects rational thinking and lowers inhibitions, alcohol can be a risk factor for suicide. Hence, remove alcohol from the home or keep in small amounts only.

3. Medications

Prescription medications should be locked up. People who are depressed often overdose on the very medications that they are prescribed for depression. Fortunately, in general, newer medications prescribed for depression (such as Fluoxetine/ProzacTM Fluvoxamine/LuvxTM, Sertraline/ZoloftTM, Paroxetine/PaxilTM, Citalopram/CelexaTM) are significantly safer than the older medications, even in overdose. Nonetheless, it is still best to lock them up anyways.

Make sure that when prescriptions are filled, that you have safe amounts of medication on hand, which makes it harder to overdose. Ask the physician or pharmacist to dispense safe amounts.

Supervise your child when s/he takes medication(s).

Dispose of all unused or out-of-date medications, by taking them to the local pharmacy for disposal.

Lock up or get rid of over-the-counter medications such as acetaminophen (TylenolTM), acetylsalicylic acid (AspirinTM, or ASA). These medications can be dangerous in overdose, so it is safest to remove them from the home.

4. Remove any other means of suicide

Remove or lock up cords, ropes, sharp knives, or other obvious means of self-harm.

5. Car keys

Remove access to car keys as a car can be used to harm oneself

6. Lock up things in the car

If you don't have other options to lock up things, then firearms or medications can be locked in a car (preferably in the trunk)

High Risk Periods

During high risk periods (such as holidays, anniversaries, or times when close supports are away, be extra cautious and check in regularly with your loved one.

Do not leave him/her alone for long periods.

If you do have to go out, take your loved one with you.

If you have to go out, but your loved one is unable (unwilling) to come along, then you might try asking a friend/neighbour to be with them if you have to go out.

In addition, during an an emergency, you can always contact:

911

A Crisis Hotline

Making an emergency action plan ahead of time is helpful and will reduce stress if it is ever needed. During a crisis is not the best time to be running around trying to find information or phone numbers.

My Crisis Plan

This is an example of a crisis plan where you can write down all the essential information that you need, should a crisis ever arise and you need to take your loved one to the hospital, for example.

Person(s) (and their phone numbers) that I can call day or night for support

Helpful people that my child trusts in the event of an emergency (names and phone numbers) (For example, these would be helpful people that could help persuade him/her to get help, accompany you to the hospital, etc.)

Here are some additional things to know if you are going to the hospital emergency room (in response to suicidal or violent episodes):

If possible, it is best to have your relative go to the hospital willingly, as opposed to forcing your relative to go.

If your relative will not listen to you, ask someone else whom he or she trusts to convince him or her to go to the hospital.

Try to offer your relative a sense of control, by giving limited choices, such as "Will you go to the hospital with me, or would you prefer to go with John?" This gives your relative more of a sense of being a part of the plan.

At the emergency department, if your child is aged your child ask to speak directly with the that you speak directly with the doctor, social worker or nurse. Find out whether your relative will be admitted. If not, find out what follow-up treatment is recommended.

If the hospital decides to discharge your relative home, but you feel that your relative should be admitted for his or her safety, you can tell the physician in charge that you do not feel that it is safe to take the person home. Recognize that mental health professionals in an emergency room deal with mental health crises regularly, so they may have a higher tolerance for mental health distress than you. Nonetheless, you can still ask the professional to explain to you why he or she feels that the decision is a safe one, and for advice on how to deal with things should your relative go home.

About this Document

Written by the eMentalHealth Team.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

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Workplace Accommodation

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Examples of Common Workplace Accommodations
Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:
Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be f...

Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:

Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be from within the organization.

Flexible scheduling to accommodate effects of medications, time for appointments, more frequent breaks, switch to temporary part-time hours without fear of losing job.

Changes in supervision, for example how feedback and instruction are given, or having weekly supervision appointments to check in and prevent problems before they can happen.

In training, allowing more time for tasks to be learned, or allowing for individualized, one-on-one training.

Appropriate technology like a tape recorder to tape instructions, head phones to block out loud noise, etc.

Modifying work space or changing location so it is quieter, fewer distractions; allowing an employee to work at home.

Allowing an employee to exchange minor job tasks with others.

Rights and Responsibilities of the Employer & Employee

The Employer Should:

Create and maintain an atmosphere where people feel comfortable asking for accommodation, including providing information about the organization’s policies and creating ways for requests to happen confidentially.

Assume that the employee’s request for accommodation is made in good faith.

In a timely manner, work with the employee (and a professional, if necessary), to explore all options for accommodation.

Maintain records of the request and steps taken to deal with the request.

Maintain and respect confidentiality issues.

Pay the cost of the accommodations, including fees for any medical certificates required.

Request only information that is directly related to developing an appropriate accommodation.

Ensure that managers and supervisory staff will not tolerate any discrimination or harassment as a result of an illness or an accommodation.

The Employee Should

Tell the employer you need an accommodation, due to a disability, and give them the information they need to understand what the limitations are and what accommodations would address them.

External Links

This manual has been written for people who want to develop and implement suicide prevention programs. The authors have done their best to present this information in a positive, culturally respectful and straightforward way. Take what you can, modify it so it is more likely to work for you. It is important to note that this manual is only able to focus on the first important stage of addressing the suicide problem: prevention. It is hoped that future manuals might address later stages such as crisis management, treatment, and postvention.

Coping with Suicidal Thoughts is intended for individuals who are currently experiencing suicidal ideation and/or have had a plan or made an attempt to hurt themselves. The document is designed to offer resources, information, support, and practical steps to help cope with suicidality.

Online service to help you find the help you need for depression, anxiety, and other mental health and substance use conditions. This includes:
* Local support groups and health services within Vancouver, Richmond, and Coastal communities
* Online information pages and workbooks provided through BC Partners for Mental Health and Addictions Information and other trusted BC sources
* Self-help or supported self-help programs such as the BC Canadian Mental Health Association’s Bounce Back® Online (available without a doctor’s referral)
* Valuable resources for friends and family members seeking information for their loved ones.

Vancouver Coastal Health/ Providence Health Care

Audience: Public (www.ementalhealth.ca)

Resource type: Mobile app, such as for iOS, Android, etc., Movies and videos, Printed materials including handouts, brochures and books, Websites including blogs, support forums

OurHealthyMinds is about mental health. It celebrates the many ways we can be well, and honours the many ways we can experience mental illness - as an individual, a caregiver, a parent, a child or loved one.

Workplace Accommodation

Add to Info Cart

Examples of Common Workplace Accommodations
Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:
Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be f...

Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:

Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be from within the organization.

Flexible scheduling to accommodate effects of medications, time for appointments, more frequent breaks, switch to temporary part-time hours without fear of losing job.

Changes in supervision, for example how feedback and instruction are given, or having weekly supervision appointments to check in and prevent problems before they can happen.

In training, allowing more time for tasks to be learned, or allowing for individualized, one-on-one training.

Appropriate technology like a tape recorder to tape instructions, head phones to block out loud noise, etc.

Modifying work space or changing location so it is quieter, fewer distractions; allowing an employee to work at home.

Allowing an employee to exchange minor job tasks with others.

Rights and Responsibilities of the Employer & Employee

The Employer Should:

Create and maintain an atmosphere where people feel comfortable asking for accommodation, including providing information about the organization’s policies and creating ways for requests to happen confidentially.

Assume that the employee’s request for accommodation is made in good faith.

In a timely manner, work with the employee (and a professional, if necessary), to explore all options for accommodation.

Maintain records of the request and steps taken to deal with the request.

Maintain and respect confidentiality issues.

Pay the cost of the accommodations, including fees for any medical certificates required.

Request only information that is directly related to developing an appropriate accommodation.

Ensure that managers and supervisory staff will not tolerate any discrimination or harassment as a result of an illness or an accommodation.

The Employee Should

Tell the employer you need an accommodation, due to a disability, and give them the information they need to understand what the limitations are and what accommodations would address them.